| NPI | 1730642901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI DOS-2352) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS19061) |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: FL UO6718) | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2023-07-11 |